Female genital mutilation

Female genital mutilation (FGM) is a practice that involves altering or injuring the female genitalia for non-medical reasons. It is internationally recognized as a human rights violation. Globally, it is estimated that between 100 million to 140 million girls and women alive today have undergone some form of FGM. If current trends continue, 15 million additional girls between ages 15 and 19 be subjected to it by 2030.

Female genital mutilation (FGM) is a practice that involves altering or injuring the female genitalia for non-medical reasons. It is internationally recognized as a human rights violation. Globally, it is estimated that between 100 million to 140 million girls and women alive today have undergone some form of FGM. If current trends continue, 15 million additional girls between ages 15 and 19 be subjected to it by 2030.

To promote the abandonment of FGM, coordinated and systematic efforts are needed, and they must engage whole communities and focus on human rights and gender equality. These efforts should emphasize societal dialogue and the empowerment of communities to act collectively to end the practice. They must also address the sexual and reproductive health needs of women and girls who suffer from its consequences.

UNFPA, jointly with UNICEF, leads the largest global programme to accelerate the abandonment of FGM. The programme currently focuses on 17 African countries and also supports regional and global initiatives.

What is FGM?

FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury the female genital organs for non-medical reasons. It is a deeply entrenched social and cultural norm in many places.

The practice can cause short- and long-term health complications, including chronic pain, infections, increased risk of HIV transmission, anxiety and depression, birth complications, infertility and, in the worst cases, death. It is internationally recognized as an extreme violation of the rights, health and integrity of women and girls.

FGM violates human rights principles and standards – including the principles of equality and non-discrimination on the basis of sex, the right to freedom from torture or cruel, inhuman or degrading punishment, the right to the highest attainable standard of health, the rights of the child, and the right to physical and mental integrity, and even the right to life, among others.

In 2012, the United Nations General Assembly unanimously adopted the first-ever resolution against female genital mutilation, calling for intensified global efforts to eliminate the practice.

Why is FGM still practiced?

In every society where it is practiced, FGM is a manifestation of deeply entrenched gender inequality. It persists for many reasons. In some societies, for example, it is considered a rite of passage. In others, it is seen as a prerequisite for marriage. In some communities – whether Christian, Jewish, Muslim – the practice may even be attributed to religious beliefs.

Because FGM may be considered an important part of a culture or identity, it can be difficult for families to decide against having their daughters cut. People who reject the practice may face condemnation or ostracism. Even parents who do not want their daughters to undergo FGM may feel compelled to participate in the practice.

Encouraging abandonment

Collective abandonment, in which a whole community chooses to no longer engage in FGM, is an effective way to address the practice. It ensures that no single girl or family will be disadvantaged by the decision. Many experts hold that FGM will only end through collective abandonment.

The decision to collectively abandon FGM requires a process in which communities discuss, reflect and reach consensus on the issue. The health and human rights aspects of FGM should play an important role in these dialogues.

When communities choose to abandon the practice, they often participate in a collective public affirmation, such as signing and circulating a public statement or hosting festivities to celebrate the decision. Neighbouring communities are often invited to these events so they can see the successful process of abandonment, helping to build momentum for collective abandonment elsewhere.

Medicalization

About 1 in 5 girls who have been subjected to FGM had the procedure performed by a trained medical professional. In some countries, this number is as high as 3 in 4 girls. UN programmes on the ground report that health workers sometimes do not even use medical facilities for fear of being caught.

What UNFPA is doing

In 2008, UNFPA and UNICEF established the Joint Programme on FGM/C, the largest global programme to accelerate abandonment of FGM and to provide care for its consequences. This programme works at the community, national, regional and global levels to raise awareness of the harms caused by FGM and to empower communities, women and girls to make the decision to abandon it.

UNFPA helps strengthen health services to prevent FGM and to treat the complications it can cause. UNFPA also works with civil society organizations that engage in community-led education and dialogue sessions on the health and human rights aspects of the practice. The Fund works with religious and traditional leaders to de-link FGM from religion and to generate support for abandonment. And UNFPA also works with media to foster dialogue about the practice and to change perceptions of girls who remain uncut.

With the support of UNFPA and other UN agencies, several countries have passed legislation banning FGM and developed national policies to achieve its abandonment.

FGM in the Arab Region

FGM is widely prevalent in some Arab countries: it affects 87 percent of women and girls in Egypt and in Sudan, 98 percent in Somalia, 93 percent in Djibouti and 19 percent in Yemen. These rates cover women and girls aged 15-49 today, and most of them underwent the mutilation at the hand of medical personnel (a doctor, a nurse or health worker) - this is what we call “medicalization of FGM”: 78% in Egypt and 77 percent in Sudan.

FGM is a strongly established and celebrated practice in the communities that perpetrate it. It is a deeply rooted social norm that is often falsely justified with health and religious arguments. FGM is generally not considered a priority issue for policymakers in the affected countries, and even less so when a conflict hits the country, such as Yemen, Somalia and (intermittently) Sudan.

During conflicts, lack of access of social and health workers to communities contributes to perpetration of the practice. Situations of political and economic instability often delay the implementation of activities that focus on anti-FGM policies and legislations. In addition, the almost systematic association of FGM with Islam, and the vulnerable status and role of women in society and within the national laws remain a challenge. Despite many religious leaders openly advocating for the total abandonment of FGM, citing religious texts to demonstrate that FGM is a cultural rather than a religious requirement, there are still strong, vocal groups of traditional, religious and political leaders who advocate for Sunna FGM (type 1), arguing that it is a less-invasive and religiously required procedure.

Medicalization of FGM a key concern

Medicalization of FGM is when healthcare providers are involved in the performance of FGM, which is likely to create a sense of legitimacy for the practice. It gives the impression that the procedure is good for health, or at least that it is harmless; this can further contribute to the institutionalization of the practice, rendering it a routine procedure. UNFPA advocates for real implementation of the laws in place: it is great to have FGM banned under the law, but what is important is to make sure the laws are implemented and perpetrators receive punitive measures. The involvement of health workers is particularly dangerous as families feel safe in their hands, whereas the practice is harmful with or without a medical staff member!

UNFPA’s response

UNFPA works with ministries of health and doctors syndicates to reiterate that medical staff should stand adamantly against practices that are dangerous to the health of girls and women, and absolutely not encourage their perpetration.

The Fund has also been urging the medical community to support the issuance of laws and make recommendations to the concerned authorities to penalize any member of the medical syndicate/council/association, who was proven to have performed FGM; penalties could reach the dismissal of the member from these bodies and the withdrawal of the medical license.

Progressing towards ending FGM in the Arab region

A lot of progress has been made against FGM in the Arab region. In Egypt, UNFPA, in collaboration with the National Population Council, played a crucial role in the work leading towards the 2016 amendment of the law prohibiting Female Genital Mutilation. The new amendment makes the practice of FGM a felony rather than a misdemeanor, increasing the penalty to range from 5-7 years, with a maximum sentence of up to 15 years, if the practice leads to death or permanent disability. In addition, any person who accompanies the girl to undergo the procedure, will also be sentenced from 1 to 3 years. In Sudan, 2017 witnessed 107 new community declarations of the abandonment of FGM, which UNFPA has supported. This means that approximately 11,000 families/68,000 members declared to leave their girls uncut. The total number of public declarations of abandonment in Sudan, exceeded 1,054 communities (cumulative) for the period 2014-2017. In Djibouti, UNFPA, in collaboration with the Ministry of Women and the Djiboutian Women’s Union, developed a referral protocol for the management of FGM cases and defining the role of the social, judicial and medical sectors. Somalia has seen a significant decline in infibulation – type 3 of FGM (also known as pharaonic); this represented a critical shift in the norm. Whilst all this does not represent “total abandonment”, these steps have nevertheless reduced the harmful impact of FGM on girls, with qualitative data suggesting a sharp decline of the practice in urban areas, as well as in some rural areas. The dissemination of information on the health impacts and risks of infibulation, particularly when Ministries of Health are involved usually have huge impact on religious and community leaders, convincing many that this practice is also in violation of Islam.